1. Childhood Wellness and Obesity: Tools to Help Schools Take Action Princeton, NJ March 31, 2006 Childhood Wellness and Obesity: Tools to Help Schools Take Action Princeton, NJ March 31, 2006 James S. Marks, M.D., M.P.H. Senior Vice President Robert Wood Johnson Foundation

2. 2 FUTURE OF CHILDREN

3. 3 No Data <10% 10%–14% OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1985 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC.

4. 4 OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1986 (*BMI  30, or about 30 lbs overweight for 5’4” person) No Data <10% 10%–14% Source: Behavioral Risk Factor Surveillance System, CDC.

5. 5 OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1987 (*BMI  30, or about 30 lbs overweight for 5’4” person) No Data <10% 10%–14% Source: Behavioral Risk Factor Surveillance System, CDC.

6. 6 OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1988 (*BMI  30, or about 30 lbs overweight for 5’4” person) No Data <10% 10%–14% Source: Behavioral Risk Factor Surveillance System, CDC.

7. 7 OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1989 (*BMI  30, or about 30 lbs overweight for 5’4” person) No Data <10% 10%–14% Source: Behavioral Risk Factor Surveillance System, CDC.

8. 8 OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1990 (*BMI  30, or about 30 lbs overweight for 5’4” person) No Data <10% 10%–14% Source: Behavioral Risk Factor Surveillance System, CDC.

9. 9 OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1991 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. No Data <10% 10%–14% 15%–19%

10. 10 OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1992 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. No Data <10% 10%–14% 15%–19%

11. 11 OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1993 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. No Data <10% 10%–14% 15%–19%

12. 12 OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1994 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. No Data <10% 10%–14% 15%–19%

13. 13 BRFSS, 1995 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. No Data <10% 10%–14% 15%–19% OBESITY TRENDS* AMONG U.S. ADULTS

14. 14 BRFSS, 1996 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. No Data <10% 10%–14% 15%–19% OBESITY TRENDS* AMONG U.S. ADULTS

15. 15 BRFSS, 1997 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. OBESITY TRENDS* AMONG U.S. ADULTS No Data <10% 10%–14% 15%–19% ≥20

16. 16 BRFSS, 1998 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. OBESITY TRENDS* AMONG U.S. ADULTS No Data <10% 10%–14% 15%–19% ≥20

17. 17 BRFSS, 1999 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. OBESITY TRENDS* AMONG U.S. ADULTS No Data <10% 10%–14% 15%–19% ≥20

18. 18 BRFSS, 2000 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. OBESITY TRENDS* AMONG U.S. ADULTS No Data <10% 10%–14% 15%–19% ≥20

19. 19 BRFSS, 2001 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. OBESITY TRENDS* AMONG U.S. ADULTS No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

20. 20 BRFSS, 2002 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. OBESITY TRENDS* AMONG U.S. ADULTS No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

21. 21 BRFSS, 2003 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. OBESITY TRENDS* AMONG U.S. ADULTS No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

22. 22 BRFSS, 2004 (*BMI  30, or about 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC. OBESITY TRENDS* AMONG U.S. ADULTS No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

23. 23 DIABETES TRENDS* AMONG U.S. ADULTS Sources: Mokdad et al., Diabetes Care 2000;23(9):1278–83; JAMA 2001;286(10):1195–2000 No Data 10% BRFSS, 1990, 1995, 2001 (*Includes Gestational Diabetes) 1990 1995 2001

24. 24

25. 25 Percent Percentage of children with BMI at or above the age- and gender-specific 95 th percentile. 0 5 15 20 10 1963-671966-70 1971-74 1976-80 1988-94 1999-2000 Ages 6-11 years Ages 2-5 years Institute of Medicine; Preventing Childhood Obesity, 2005 PREVALENCE OF CHILDHOOD OBESITY

26. 26

27. 27 BIGGER CASKETS, STRETCHERS

28. 28 COSTS OF OBESITY State budgets Global competitiveness National security

29. 29 ENERGY BALANCE

30. 30 CONSUMING MORE Eating out Bigger portion sizes Competitive foods in schools Sugar-sweetened beverages

31. 31 BURNING LESS Little or no P.E. in schools Few kids walk and bike to school Screen time

32. 32 IOM REPORT Causes and potential solutions Call to action for all sectors

33. 33 RWJF FOCUS Schools and communities Children ages 3-12 Kids at greatest risk

34. 34 RWJF APPROACH Putting the best minds to work Testing innovative approaches Educating leaders and advocates

35. 35

36. 36 HEALTHY SCHOOLS PROGRAM Healthier choices at same or lower cost Focus on schools with fewest resources Physical activity and nutrition standards School recognition program Staff wellness

37. 37 Important issues Long-term commitment Making a difference